NPI | 1336396811 |
---|---|
Former Name | D JEANINE KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209003941) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209003941) |
163W00000X Registered Nurse (Licence: IL 041226779) | |
Enumeration Date | 2008-08-26 |
Last Update Date | 2024-03-14 |